Emergency Department Education

Reduce healthcare costs and improve access with our live telephonic education and guidance.

Misuse of the Emergency Room creates unnecessary costs for all involved and prevents medical personnel from tending to those who are truly experiencing an emergency. Care delivered in Emergency Department settings for non-emergent conditions is noted as a primary driver of the skyrocketing cost of healthcare in the United States. It is estimated that more than $18 billion could be saved annually if those patients whose medical problems are considered “avoidable” or “non-urgent” were to take advantage of primary or preventive healthcare and not rely on ERs for their medical needs.

Evidence also supports that Medicaid participants typically enter the healthcare system via the Emergency Department at rates higher than other groups. We understand that active outreach is beneficial in educating those you care for and is a necessary component to enhancing the total well-being of the population.

With NurseWise as your health risk measurement partner, you can rest easy knowing that you have a dedicated team of clinical professionals on your side.

Our data shows that 25%
of triage callers initially intended to visit the ER—but after talking with us, 91% followed our nurse’s advice. Imagine how many people you could affect by educating them before an incident happens! 1

Based upon our data, the nine most common reasons people visit the ER are not actual emergencies:

er-visit-infographic

By educating those you care for about other places to receive care, when to wait to see a primary care provider and when to call the nurse advice line, you can reduce the use of the ER for non-emergent situations.

There’s a downside for those visiting the ER, too. From lack of comprehensive care and unclear knowledge of patient history to limited counseling time from those in the ER due to other emergencies, having a continuity of care is difficult when the ER is used as a primary care facility.

Health plans, along with hospitals and doctors, are realizing the importance of a collaborative effort to coordinate patient care and recommend the most appropriate level of care. Using the ER, despite the actual seriousness of an injury or illness, has resulted in inflated and unnecessary healthcare costs across our nation. By partnering with us, you can empower those you care for to make the best choice for where to get care, reduce your costs incurred by overuse of the ER and improve your customer engagement.

During outreach, our nurses provide participants with:

  • The benefits available to them.
  • How to contact Member Services with questions.
  • How to access on-call Primary Care Providers (PCP) after normal business hours.
  • The availability of PCPs with extended clinic hours.
  • The availability and location of urgent care centers.
  • Instant, round-the-clock access to a healthcare professional through the Nurse Advice Line and guidance on when to call.

Client benefits include:

In a recent study, a NurseWise client realized a 6% decrease in use of the ER by those who participated in the program as compared to a similar group that did not participate in the program. The result? An estimated annualized savings of $1.3 million for the study group, equating to an ROI of 2.4:1. 2
  • A program that has proven both successful and, more importantly, self-funding.
  • Early identification and intervention with targeted population.
  • Live telephonic outreach—a proven method—to start a dialogue and share information with those you care for (or their guardians).
  • Valuable results from the health needs screenings.
  • Monthly scorecards with actionable and easy-to-use information.
  • Coordination of follow-up for ongoing support for those with high needs.
  • Reduced preventable emergency room visits.
  • A reasonably priced program that yields proven results and savings.
  • Empowerment of those you care for through increased self-confidence in assessing their own healthcare decisions and determining the best place to receive care.
  • Promotion of a partnership between you and those you care for by improving the access to and quality of care. By interweaving education and screening, the program encourages a trusting, positive relationship.
  • A more educated population that is armed with the tools necessary to make better decisions about how and where to access the healthcare system.
  • The ideal solution for those who do not have a primary care provider for themselves or their dependents.

1 Source: 2013 Nurse Advice Line Book of Business
2 Source: 2013 State health plan client’s data for Nurse Advice Line